Strategies in Trauma and Limb Reconstruction

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VOLUME 14 , ISSUE 2 ( May-August, 2019 ) > List of Articles

Original Article

Patient-reported and Functional Outcomes of Bi-condylar Tibial Plateau Fractures Managed by Internal Screw Fixation in Combination with An Ilizarov Fixator: A Case Series of 22 Patients with Long-term Follow-up

Peter Larsen, Jens Traerup, Mindaugas Mikuzis, Rasmus Elsoe

Keywords : Complex bicondylar tibial plateau fractures: long-term follow-up, Functional outcomes, Internal fixation combined with external ring fixation, Patient-reported outcomes

Citation Information : Larsen P, Traerup J, Mikuzis M, Elsoe R. Patient-reported and Functional Outcomes of Bi-condylar Tibial Plateau Fractures Managed by Internal Screw Fixation in Combination with An Ilizarov Fixator: A Case Series of 22 Patients with Long-term Follow-up. 2019; 14 (2):85-91.

DOI: 10.5005/jp-journals-10080-1432

License: CC BY-NC-SA 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: The objective of this case series was to report the long-term patient-reported and functional outcomes of complex bicondylar tibial plateau fractures in patients treated with internal fixation in combination with an Ilizarov fixator. Materials and methods: A retrospective series of cases. Patient-reported, radiological and functional outcomes were obtained with a mean of 9.4 years’ follow-up. Results: Twenty-two patients completed the follow-up. At follow-up, the mean age was 52.2 years, ranging from 26 to 69 years. The gender distribution was 14 males and 8 females. The mean knee injury and osteoarthritis outcome score (KOOS) was pain 72.5, symptoms 62.7, ADL 75.9, sport 35.4, and knee related quality of life (QOL) 56.4. Compared to a reference population, the present study reported worse outcome for the subscales: symptoms, sport, and QOL. The maximal isometric muscle strength for knee extension was 354N for the noninjured leg and 325N for the injured leg (p = 0.27). Assessment of gait functions showed a gait speed of 122.7 cm/second and a cadence of 112.7 steps/minute. Gait speed and cadence showed no significant difference when compared to a reference population. Radiological examination of knee osteoarthritis (OA) showed 6 patients presented with none OA, 13 patients with mild OA, and 3 patients with severe OA. Conclusion: Complex bicondylar tibial plateau fractures are associated with long-term decreased knee structure-specific patient-reported outcome (KOOS). In contrast, most patients presented with satisfactory long-term radiological and functional outcomes. More research is needed to understand the complex association between patient-reported outcomes and radiological and functional outcomes. Level of evidence: IV. Series of cases.


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